Important information to Clients
Information about Optometrists’ withdrawal from Ontario’s Health Insurance Plan
Impact for Ontarians ages 19 and younger and 65 and older
The Ontario Association of Optometrists is planning to withdraw from Ontario’s Health Insurance Plan (OHIP) on September 1, 2021.
Currently, OHIP pays for one annual routine eye exam for Ontarians ages 19 and younger and 65 and over.
This could mean some Ontarians will not be eligibly for a routine eye exam should OAO withdrawal from OHIP
- Optometrists may refuse to provide routine eye exams to people ages 19 and under, and 65 and over.
- By law, Optometrists cannot charge patients in these age groups directly for eye exams, as they are OHIP eligible benefits. In other words, patients cannot pay directly for the service.
- Under the same law, insurers cannot cover the costs of their routine eye exam, either. This includes workplace plans and private insurance plans.
What does this mean for plan members?
If your plan covers plan members or dependents ages 19 years and younger, or 65 and over:
These dependents will no longer have access to obtain an eye exam from an Optometrist. There are no benefits available through the Extended Health Care, because there will be no service offered to cover.
No matter the outcome, your carrier will continue to pay eligible claims for eye exams for Ontarians ages 20 to 64, inclusive, as usual. Nothing changes with regard to the current vision coverage provided through your employee benefits plan(s).
The JDB group will continue to monitor the situation through the Canadian Life and Health Insurance Association (CLHIA). We will advise you of any changes.
Questions? We’re here to help.
Contact your JDB Group Consultant today!
